The Devil’s Playground

The Constant Gardener

by John le Carré
Scribner, 492 pp., $28.00

On April 19 of this year, in South Africa, thirty-nine drug companies jointly withdrew from a lawsuit aimed at protecting their patents. The suit had been brought by the pharmaceutical giants in response to a law passed in 1997, which allowed the South African health ministry to buy copies of branded drugs; the law gave the go-ahead to local and foreign manufacturers to ignore patents and sell generic copies at a price local markets could bear. The withdrawal of the pharmaceutical companies’ action was a significant moral victory for the South African administration, which governs a population in which deaths from AIDS are said to run at five thousand a week.

The practical results remain to be seen. The 1997 law had not been implemented, and probably never will be. The likely reward for the drug companies will be a say in drawing up a new regulatory framework. When and how the benefits will reach the sick people of South Africa is hard to determine. But the outcome of the case has implications for the whole developing world. In backing off, the companies swallowed the bitter pill of adverse public opinion, and recognized that their position was unsustainable. They cannot, practically or ethically, sell drugs that treat AIDS, malaria, and tuberculosis to third-world countries according to the pricing structure they employ to sell drugs for baldness, impotence, and the maladies of affluence. From now on, drug prices will have to be linked in some way to ability to pay; the pharmaceutical companies will have to find a new business model, and gnaw their knuckles over the unwelcome possibility that cheap generic drugs will be trafficked back from the third world to collapse their markets in Europe, North America, and Japan.

No one need shed tears for them. The industry remains highly profitable, and nothing can prevent pharmaceutical companies from switching their research efforts to “lifestyle” drugs for which their promotional arms can help create a demand. And of course, the companies stand accused of worse things than profiteering. There is longstanding concern about the way clinical trials are conducted in emerging countries; about the off-loading of inappropriate and out-of-date stock; about the way in which, it is thought, drug companies’ willingness to place their product by buying up the local bosses allows corruption to flourish both at the ministerial level and on the ground.

In his latest, passionately committed novel—a polemic cast in the form of a thriller—John le Carré adds the charge that the drug companies are involved in the insidious, methodical corruption of scientific opinion. The drug companies buy favors by giving money to universities. Researchers are corrupted and inconvenient conclusions suppressed. Inconvenient scientists are also suppressed—hounded out of their positions and their reputations ruined. The world’s most reputable medical journals give space to papers which are little more than corporate propaganda with a professor’s name at the end. And why does the media not expose these issues? It does, in fact, but not, le Carré seems…

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